Organization
SOUTHERN RADIOLOGY SERVICES
Active
Other names
Raghava A. Bhaskaran, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
RAGAHAVA A BHASKARAN M.D. (PHYSICIAN)
(478) 274-1100
Entity
Organization
Contact information
Practice address
606 ACADEMY AVENUE, DUBLIN, GA 31021
(478) 274-1100
(478) 274-1166
Mailing address
P. O. BOX 1527, DUBLIN, GA 31040
(478) 274-1100
(478) 274-1166
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
025580
GA
2085R0202X
Diagnostic Radiology Physician
025580
GA
2085U0001X
Diagnostic Ultrasound Physician
025580
GA
208D00000X
General Practice Physician
Primary
025580
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000321417E
—
GA
01
—
297149
WELLCARE
GA
Enumeration date
10/04/2006
Last updated
06/21/2018
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